Evaluation of Red Eye; June 2014

Red Eye EvaluationThis work shop is for GP’s and Specialists and will focus on how to proceed if you see a patient with red eye in your clinic.

The only thing we will presume is that you have access to a torch or at-least a mobile with torch function.

IMA Trivandrum Meeting 29 Feb June 2014

Dr. Devin Prabhakar MS,FRCS Dr. Kavitha Devin DO, DNB

www.DivyaPrabha.in

Top 10 causes of Red Eye

1. Conjunctivitis2. Uveitis3. Acute Angle Closure Glaucoma4. Episcleritis, Scleritis5. Subconjunctival Hemorrhage6. Dry Eye7. Blepharitis & Meimbomianitis8. Injury9. Corneal Ulcer10.Frequent eye drops

Bacterial ConjunctivitisMucopurulent orCatarrhal

DescriptionCommonly caused by S. aureus, S. pneumoniae, and H. Influenzae (pediatrics). Involvement of

1 eye followed 1-2 days later by the other eye. Conjunctival redness.

Viral Conjunctivitis

Watery

DescriptionCommonly adenoviruses. Bilateral. Contagious. Enlarged preauricular nodes, corneal infiltrates,

and follicular conjunctivitis.

DescriptionToxic reaction (keratitis) due to overuse of antibiotics, sympathomimetics, miotics, beta-blockers, topical anesthetics, etc. with no underlying immune dysfunction.

Toxic Medicamentosa

Lids Symptoms include ScratchingLid swelling Lid thickening Lid notches Loss of lashesCrusts

Blepharitis

Meibomitis

Lids

Lids

Symptoms • burning • stinging• dryness• irritation

Associated w/ Dry Eye

Signs

• pouting of meibomian gland

• blockage of meibomian gland

• scarring of meibomian gland

Dry Eye

DescriptionCharacterized by dryness, foreign body sensation, burning and tearing. Mild redness, often corneal and conjunctival staining. Many causes including decreased circulating hormones, menopause, lid disease, autoimmune disease, drying medications, meibomian disease, environmental factors.

X

X

DescriptionAngry red eye; corneal epithelial and stromal necrosis evident by opacity and fluoroscein staining. Painful and photophobic. Generally bacterial.

Corneal Ulcer

Hyperemia and chemosis of inferior bulbar conjunctiva

Allergic folliculosis due to topical alpha adrenergic agonist

Drug-induced Allergic Conjunctivitis

Management of Conjunctivitis•Prophylaxis•Hygienic measures•Local Antibiotics•Look for corneal lesions•Avoid steroid e/d

Management of Blepharitis•Eye lid shampoo•Warm compress•Artificial tears•Erythromycin ointment qid to lids•Restasis for meibomitis•Antibiotics

•Tetracycline 250 mg qid 2 weeks •Doxy 100 •Erythromycin 200 mg bd

•Look for pediculosis

Dry Eye

•Environmental factors•Personal habits

•Medications

•Antihypertensives,

•Antihistamines,

•Antidepressants

•Post-surgical.

•Discourage from Contact lens,LASIK

Management of dry eyeMild dry eye:

• Artficial tears: Refresh Tears [carboxy methyl cellulose], Tears Natural [Hydroxypropyl Methyl cellulose],Systane [polyethylene glycol and propylene glycol],Genteal [hydroxy propyl Methyl cellulose],etc

• Ocular hygiene

• Proper specs

• Treat predisposing factors

Severe dry eye

Restasis,

Mucus strands removal

Lat tarsorrhaphy

Adhesive tape

Moderate dry eye: • increase frequency of Artificial

tears,

• opt for preservative free

• Add ointment

• Punctal occlusion

• Restasis eye drops

How Many People Are Affected by Allergy?According to the Gallup Study of Allergies*:

OcularSymptoms

No OcularSymptoms

50% of the population has allergies

83% of allergy sufferers experienceocular symptoms

* Data from 2003-2004 survey.

Common Causes of Ocular Allergies

Vernal Keratoconjunctivitis (VKC)Vernal Keratoconjunctivitis (VKC)Signs/Symptoms: Ptosis Ropy mucous discharge Photophobia Large, nonuniform cobblestone papillae

Trantas dots Limbal nodules Neovascularization Shield ulcers Itching Frank inflammation with leukocyte influx

Divya Prabha Eye Hospital 0471-2442050

Acute Angle Closure Glaucoma

Divya Prabha Eye Hospital 0471-2442050

Divya Prabha Eye Hospital 0471-2442050

Forgein Body

Divya Prabha Eye Hospital 0471-2442050

Divya Prabha Eye Hospital 0471-2442050

Divya Prabha Eye Hospital 0471-2442050

Divya Prabha Eye Hospital 0471-2442050

Watch out if• History

– Pain– Blurred Vision

• Examination– Circumcorneal Conjestion– Steamy cornea– Corneal Opacity– Pupil reaction– Hypopyon

Thank You !!

www.Facebook.com/DevinPrabhakarwww.DivyaPrabha.inMobile: 9388342050

Divya Prabha Eye HospitalKumarapuram Kannanmoola Road

Trivandrum, KeralaIndia